communities preventing childhood obesity priester 2013
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The Communities Preventing Childhood Obesity project Multi-state
IN, KS, MI, ND, OH, SD, WI
Multi-disciplinary team Nutrition Physical activity Community development Family and youth development
Funded by USDA Agriculture and Food Initiative (AFRI) Grant
GOAL: Start a community
development intervention to
prevent childhood obesity.
Innovative Aspects
7 states collaborating
Community capacity development approach
Ecological Model of Childhood OverweightRural communitiesLow-income familiesPreschool-aged children
Ecological Model of Childhood Overweight
Weight Status
Ethnicity
School lunch progra
m
Work deman
ds
Neighborhood safety
Socioeconomic status
School PE
programs
Accessibility of recreational facilities, convenience foods, and restaurants
Foods availabl
e in home
Nutritional
knowledge
Parent’s dietary intake
Encouragement of
activity
Parent’s activity patterns
Monitoring TV hours
Parent’s weight statusDietary
intake
Sedentary behaviors
Physical
activity
Growing evidence shows that obesity is driven by the environment. (Schwartz & Brownell, 2005)
Community Development Approach
For people to make behavior changes that support healthy lifestyles, they must exist in an environment where the healthy choice is the easy choice.
Environmental changes can improve the health of the whole community, not just individuals.
Making an ImpactHow can
Extension help a community
impact the environment?
How can a community create
an environment where the healthy choice is the easy
choice?
Community coalitions consist of public- and private-sector organizations that, together with individual citizens, work to achieve a shared goal through the coordinated use of resources, leadership, and action. (IOM, 2005)
Role of a Coalition
Coalitions:The vehicle for
successful change at the
community level!
Engage residents
in the cause
Create a sense of
community
Success of a Coalition
Relies on
capacity-building
ability of the
coalition
Barriers to Coalition Success
Lack common vision
Lack formalization
Lack clearly defined roles
Failure to reevaluate
Failure to act
Failure to commit
COMMUNITY COACHING
An effective approach to support
community development for
sustained community change initiatives
What is Community Coaching?
“A Community Coach is a guide who supports communities and organizations in identifying and achieving their goals.”
(Emery, Hubbell, & Miles-Polka, 2011)
Works as a process coach with a group or coalition Ensures efforts follow community
development principles of good practice
Coaching Effective Community Development
The process of helping citizen
groups organize and act to address
shared concerns.
A process that aims to support citizens in their
efforts to “build solidarity and agency through self-
help, felt needs, and participation”
(Bhattacharyya, 2004, p. 5)
Community development
Planned Approaches to Community Intervention
Robinson &Green (2011)
At the Heart of CoachingProcess to identify:
Current situation
Direction and desired
outcome
Alternatives and implications
Choice making
Action planning and
implementation
Reflection, modification and
new goal setting
Community Coaching for sustained change initiatives
Prepare coalition and community
Develop effective working Relationships
Coach for Action
Help the team think community-wide
Guide the coalition to review, revise, and respond
Consider sustainable structure/ownership
Readiness
Relationships
Results
Reach
Reflection
Resiliency
Methods
14 communities
○ 2 in each state
(1 intervention, 1 control)
Comparable in size and
demographics
○ Rural community
○ Exhibit community
readiness
○ Has an existing community
coalition
All communities:
○ Child Ecological Model
Assessment
○ Receive menu of evidence-
based interventions
○ Implement 1 physical activity
and 1 nutrition intervention
○ Receive $5000/year for 4
years
Intervention communities:
○ Hire a Community Coach
○ Receive Community Coach
training
Measuring Impact
Child Ecological Model Assessment toolkit:Community Healthy Living Index assessments
○ Community-at-Large
○ Neighborhood
○ Early Childhood Program
Active Where? Parent Survey
Coalition Self-Assessment
Community Healthy Living Index
Pre-test / Post-test
Does not include
anthropometric data
Assesses
“Community and
Demographic” ringIdentifies community-
wide factors where
improvements can be
made
Assessments:Community-at-Large
Neighborhood
Early Childhood Program
http://www.ymca.net/chli-about/
Active Where? Parent Survey
Pre-test / Post-test
Assesses “Community and Demographic”
and “Parenting / Family Characteristics” ringsConsiders home, neighborhood, park, and school
environments related to physical activity and
eating
Low-income parents of preschool-aged
children
http://www.activelivingresearch.org/node/11951
Coalition Self-Assessment
Annually
Identify strengths and weaknesses
Determine if available resources are sufficient
Determine stage of readiness related to
purpose and goals of coalition
http://asthma.umich.edu/media/eval_autogen/CSAS.pdf
Overview
Toolkit
Menus of evidence-based curricula and strategiesNutrition menu
Physical activity menu
Organized by the Ecological Model of Childhood
Overweight
Updated frequently
Online access
Example resourcesToolkit
Leadership For Healthy Communities: Action Strategies Toolkit Leadership strategies and programming tools to create healthy
communities for children
Nutrition and Physical Activity Environments in Licensed Child CarePolicy strategies to promote healthy eating and increase
physical activity in child care facilities
HAPPE: Toddlers in Physical Play Motivates and engages toddlers in physical play and builds
basic motor skills that are the foundation for lifetime activity
Final year
Post assessments completed Intervention communities:
Develop sustainability plan to continue project Control communities:
Receive training in community coaching
Year 1: Community assessment
Year 3/4: Implement
interventions
Year 4:• Post
assessments• Continue
community development
How is Extension helping impact your environment?
Weight Status
Ethnicity
School lunch progra
m
Work deman
ds
Neighborhood safety
Socioeconomic status
School PE
programs
Accessibility of recreational facilities, convenience foods, and restaurants
Foods availabl
e in home
Nutritional
knowledge
Parent’s dietary intake
Encouragement of
activity
Parent’s activity patterns
Monitoring TV hours
Parent’s weight statusDietary
intake
Sedentary behaviors
Physical
activity
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Emery, M., Hubbell, K., & Miles-Polka, B. (2011). A Field Guide to Community Coaching.
Hargrove, R. (2008). Masterful coaching. Pfeiffer.
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(eds), Challenges for rural America in the Twenty-first century, University Park, PA: Pennsylvania State
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Beaulieu and D. Mulkey (Eds.), Investing in people: The human capital needs of rural America, Boulder, CO:
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Institute of Medicine. (2005)
Schwartz, M. B., & Brownell, K. (2005). The need for courageous action to prevent obesity. In D. Crawford, R. W.
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